Description: This article will consider several issues arising from ACO budgeting and pricing of stoploss coverage, including: 1) attribution of members; 2) claim carve outs; 3) ambiguous stoploss terms; 4) providers gaming the system and 5) credibility of data.

Description: This paper highlights the menace of overweight and obesity which are on the rise. Health care systems and insurance industries are directly affected. Liability claims are on waiting. The food related damage claims are costly. Insurers are therefore driven to find a solution: classify overweight and obesity as a group, adjust their premium to reflect the cost, and justify the classification and the adjustments.

Description: Employer and payers need to actively seek change in the system of mental health care deliveryoperational, clinical, and financial change. From Financing Chronic Care Monograph, M-HB05-1.

Description: This Society of Actuaries Research Brief has been constructed to highlight some of the key features of the COVID-19 epidemic and contemplate the risks for the actuarial profession to consider in their work.

Description: Early in his career, Ehren Nagel, FSA, MAAA, scoured through podcasts and articles about predictive analytics, long suspecting this was a field with potential for him.

Description: Taxes and Fees Introduced by the ACA

Description: A compilation of feedback from actuaries in the Health Section of the affects of the ACA.

Description: This 1981 session dealt with Risk Classification for Individual Health Insurance. Topics included current legislative/regulatory trends and their impact on pricing and plan design, high risk-sharing pools, and deomographic considerations. From Record of Society of Actuaries 1981 Vol. 7, No. 2.

Description: Medical and industry experts discuss Acquired Immune Deficiency Syndrome [AIDS], epidemiological projections, mortality and morbidity trends, underwriting practices, solvency and regulatory issues, future outlook, and activities of the Society of Actuaries Task Force on AIDS. From the 1987 Record of Society of Actuaries, Vol. 13, No. 4A.

Description: Successful healthcare reform: First, it must help that must keep healthy people healthy. Second, it must help people mitigate or eliminate the health-risks associated with unhealthy lifestyle behavior choices, and Third, it must ensure the provision of evidence-based care to those who are ill.